Scripties UMCG - Rijksuniversiteit Groningen
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The Influence of Maternal Obesity on Macrophage Subsets and Macrophage Angiogenesis Factors in the Human Decidua

(2018) Benthem, K.L. van (Karlijn)

Introduction Obesity in women of reproductive age constitutes a growing health problem throughout the world. Obesity during pregnancy and possibly already before pregnancy is associated with adverse maternal and fetal consequences. Macrophages might be essential in this association via an effect on the regulation of angiogenesis and placental development, and are involved in pregnancy complications. The function of macrophages is influenced by obesity. This study aims to investigate the effect of maternal obesity on macrophage subsets and the associated levels of placental angiogenic factors Flt-1, PGF and VEGF-A in the decidua of term pregnant women.
Materials and methods
Macrophages from the decidua basalis and decidua parietalis were isolated to determine, using flow cytometry, the macrophage subsets within the CD45+CD14+CD50- population with HLA-DR as activation marker. mRNA levels of CD68+, CD80+, CD163+, IRF-5, Flt-1, PGF and VEGF-A were analyzed and related to housekeeping genes. To gain insight into the M1/M2 macrophage ratio, the mRNA expression of CD80+ and CD163+ and IRF-5 and CD163+ were related to each other.
Results Placentas of 13 obese and 17 control women were included after an uncomplicated, term pregnancy. The decidua parietalis showed significant increased levels of pro-inflammatory macrophages and decreased levels of the angiogenesis factor VEGF-A in obese women. Furthermore, levels of macrophages were significantly increased in decidua parietalis compared with decidua basalis.
Conclusion This study in uncomplicated pregnancies provides essential new insights into the effects of obesity on the human placenta. Obesity during pregnancy is associated with a significant increased pro-inflammatory M1 macrophage populations and diminished angiogenetic expression of VEGF-A in the decidua parietalis. This might explain the increased risk of complications seen in obese pregnant individuals.

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